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Pharmacology 1+2 > Lab test 4: opiods, NSAID and anaesthetics > Flashcards

Lab test 4: opiods, NSAID and anaesthetics Flashcards

1
Q

What are the side effects of the ultra short acting barbiturates?

A

-Small therapeutic index, side effects can be life threatening
-Pronounced resp. dep. (dose-dependent, reversible) (serious in neonates)
-Cardiovascular dep. → hypotension → tachycardia (dose
dependent or individual sensitivity → irreversible)
-Tissue irritation (should be applied IV)
-Prae- and postnarcotic excitation

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2
Q

What are the side effects of the NMDAs? (ketamine, tiletamine)

A
  • Broad therapeutic index
  • Mild respiratory depression
  • Mild stimulant of cardiovascular system → BP,/freq. incr., arrhythmias!
  • Catalepsy!
  • Increased intracranial- and eye pressure
  • Swallow disturbances
  • Rarely: Pre/postnarcotic excitation
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3
Q

Name the pharmacological effects of benzodiazepines?

A
  • Sedative
  • Anxiolytic
  • Muscle relaxant activity
  • Pronounced anticonvulsant action.
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4
Q

Name the pharmacological effects of α2 agonists

A
  • Sedative
  • Muscle relaxant activity
  • Analgesic
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5
Q

Name the main effects of premedication for anaesthetics

A
  • Sedation
  • Reduce anxiety
  • Analgesia (Neuroleptanalgesia)
  • Decrease pre/post narcotic excitation
  • Antiemetic, reduces secretions
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6
Q

Which IV administration anaesthesia is susceptible to bacterial contamination?

A

Propofol is susceptible for bacterial contamination.

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7
Q

Name the drug for treatment of convulsions?

A

Diazepam

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8
Q

Which drug is used for the treatment of long term epilepsy?

A

Phenobarbital

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9
Q

Name the ultra short acting barbiturates that cannot be readministered?

A

Thiopental and Thiamilal.

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10
Q

Which drug is used to capture wild animals?

A

Etorphine (1000x stronger analgesic effect than morphine)

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11
Q

Describe the AMES test.

A
  • Used to see whether a given chemical can cause mutations in the DNA of the test organism, leading to cancer.
  • The test drug is mixed with top agar along with bacteria (most commonly Salmonella typhimurium) and rat liver homogenate.
  • The mixture is then spread on an agar plate containing a small amount of Histidine (growth medium allowing the bacteria to grow and have the opportunity to mutate).
  • When the histidine is depleted only bacteria that have mutated to gain the ability to produce its own histidine will survive.
  • The mutagenicity of a drug is proportional to the number of colonies observed on the agar plate after a certain time.
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12
Q

Explain teratogenicity.
How many species are needed to be tested?
Which species are they? And Why?

A
  • A teratogen is an agent that can disturb the development of the embryo or fetus. Teratogenic drugs halt the pregnancy or produce a congenital malformation (a birth defect).
  • Need to test on at least two species.
  • Usually rat and rabbit.
  • Some species may not suffer from any side effects of the teratogens and so it’s important to test on other species.
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13
Q

What sedate-hypnotic agent would you recommend to a cardiovascular patient?

A

Benzodiaziepines

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14
Q

Which drug is used for status epilepticus?

A

Phenobarbital

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15
Q

Name the NSAID’s isoenzymes.

Which one is in the CNS and which drug acts on it?

A
  • COX-1, COX-2, COX-3.

- In CNS: COX-3, act on paracetamol

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16
Q

Name the side effects of Propofol?

A
  • larger therapeutic index
  • pronounced resp. dep.
  • apnoe after quick adm! (inj. should last for 30-45sec)
  • cardiovascular dep → hypotension (can be pronounced in endocardosis, DCM)
  • because of respiratory and cardiovascular side effects their use is limited in risk patients
  • prae- and postnarcotic excitation is rare
17
Q

What is the difference between the neuroleptoanalgesia and general anaesthesia?

A
  • General anaesthesia is the loss of consciousness and reduction of motoric and sensory functions to a level, where any operation can be executed. The respiratory and cardiovascular functions are maintained.
  • Neuroleptoanalgesia is a state of indifference to, or reduced appreciation of pain brought about by the use of Neuroleptics and Analgesic drugs. Consciousness is retained. Neuroleptanalgesia allows surgery to be performed without inducing general or local anaesthesia.
18
Q

NSAIDs are harmful to which organs? What do you use to counteract them?

A
  • Liver → Give liver protectants
  • Kidneys → Give sodium bicarbonate to treat metabolic acidosis
  • G.I tract. → Give proton pump inhibitors for stomach irritation, activated charcoal for GI irritation
  • Cartilage → (prostaglandin E1 analogue misoprostol)
19
Q

(Text with blanks to fill up)
NSAID are acting on ……?…… which have minimum ……?…… isoenzymes. Among them …… ?…… is acing only on CNS and this drug is only inhibiting it ……?…… so it’s not anti inflammatory but minor analgesic.

A

NSAID are acting on ……Cox enzymes…… which
have minimum ……3…… isoenzymes. Among them ……Cox3…… is acing only on CNS and this drug is only inhibiting it ……paracetamol…… so it’s not anti inflammatory but minor analgesic.

20
Q

Name the pharmacological effects of NSAID.

A
  • Antiinflammatory
  • Antipyretic
  • Analgesic
  • Inhibition of platelet aggregation
21
Q

What are the active substances of glucocorticoids?

A

Cortisol, Prednisolone, Methylprednisolone, Triamcinolone, Betamethasone, Dexamethasone, Beclomethasone, Fluticasone.

22
Q

Name the side effects of opioids?

A

-Pronounced respiratory depression
-Bradycardia, hypotension (vasodilation)
-Vomiting
-Antitussive effect (morphine, codeine, butorphanol)
(Not so dangerous:)
-Constipation
-Urinary retention
-Excitation (CAT) → can be avoided by decr. dose, combination

23
Q

Most important side effects of NSAID’s.

A
  1. Stomach ulceration (and GI erosion, bleeding, protein loss)
  2. Kidney damage (nephropathy)
  3. Bleeding
    - Liver: hepatotoxicity: rare, but hepatopathy
    - Methemoglobinaemia
    - Allergy: anaphylactic/anaphylactoid reactions
    - Cartilage damage
24
Q

NSAIDS characteristics in dogs

A

(Almost all drugs can be used)
-Prefered: Meloxicam, Carprophine, Rimadyl, Coxib->Mavacoxib
(75% on full stomach)

25
Q

NSAIDS characteristics in cats

A
  • NO NSAIDS can be given for more than 1 week
  • Long term: Meloxicam, Robenacoxib
  • Short term: Vedaprofen, Tolfenaminic acid
26
Q

Indications for opiods

A
  • Premed.
  • Neuroleptanalgesia
  • Balanced anaesthesia (comb. - bolus, inf.)
  • Analgesia
27
Q

Name some full agonist opiods

A

Morphine, Methadone, Fentanyl, Tramadol, Codeine, Etorphine…

28
Q

Name some partial agonist opiods

A

Buprenorphine, Butorphanol, (Tramadol)

29
Q

Name som antagonist opiods

A

Naloxone, Naltrexone, Diprenorphine

30
Q

Indications for NSAIDS

A
  • Inflammation/degenerative musculoskeletal diseases (eg. arthritis, osteoarthrosis)
  • Fever
  • Prae- and post-operative analgesia
  • Endotoxaemia
  • Thrombocyte aggregation inhibition, DIC (eg. colic in horse)
31
Q

NSAIDS characteristics in horse

A

-Colic! Must be spasmolytic and should act against endotoxins
-Flunixin (slow onset og action)
(Comb. with:)
-Metamizol (quick onset, but slow action)
-Meloxicam (not spasmolytic)

32
Q

NSAIDS characteristics in Ru

A
  • Flunixin
  • Inj. options (10h): pour on
  • Meloxicam (1-2d)
  • Carprofen (5-6d)
33
Q

NSAIDS characteristics in swine

A
  • Meloxicam inj.

- Orally (water): Aspirin (stomach ulcers) or Na-salicylate (safe, second class)

34
Q

NSAIDS characteristics in poultry

A

-Orally (water): Aspirin (stomach ulcers) or Na-salicylate (safe, second class)

35
Q

Indications for barbiturates

A
  • Induction, general anaesthesia (comb.), analgesia Ø
  • Convulsive state, epilepsy (pentobarbital i.v.)
  • Euthanasia
36
Q

INJECTABLE ANAESTHETICS

A 
BARBITURATES
 PROPOFOL
 ETOMIDATE
 NMDA ANTAGONISTS
 STEROID ANAESTHETICS
37
Q

INHALATIONAL ANAESTHETICS

A

(HALOTHAN)
ISOFLURANE
SEVOFLURANE

38
Q

Side effect of inhalation anaesthetics

A
  • circulatory dep: neg. ionotropic, BP, arrhythmia (halothan)
  • hepatotoxicity (halothan)
  • nephrotoxicity (fluranes: fluorides are formed)
  • prae/postnarcotic excitation
    halothan > isoflurane&raquo_space; seroflurane
39
Q

Side effect of STEROID ANAESTHETICS (alphaxalone+alfadolone=„althesin”)

A
  • Broad therapeutic index
  • CV dep.: hypotension, neg. ionotropic
  • histamine-release -> allergy (e.g. ear)
  • postnarcotic excitation (rare)

Pharmacology 1+2 (25 decks)

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